A relatively quiet year for HIPAA enforcement is ending with a small flourish.  The Office of Civil Rights of the Department of Health and Human Services (HHS) has announced two settlements with covered entities within the span of eight days.

The first settlement involved Advanced Care Hospitalists (ACH), a company that provides internal medicine physicians to hospitals and nursing homes in Florida.  In 2014, ACH received notice from a local hospital that individually identifiable patient information had been posted on the website of a third party billing provider.  ACH reported the breach, which ultimately led to an HHS investigation. HHS found that:

  • The disclosure affected 9,225 patients.
  • ACH failed to enter into a business associate agreement with one or more vendors who had access to protected health information (PHI).
  • ACH did not implement privacy, security, or breach notification policies and procedures until after the breach was discovered.
  • ACH failed to conduct a security risk analysis until after the breach was discovered.

To settle these matters, ACH agreed to pay a $500,000 penalty and fulfill its obligations under a supervised corrective action plan that focuses on the identified failures.

The second settlement followed from a complaint lodged with HHS against Pagosa Springs Medical Center (PSMC) in Colorado.   The ensuing investigation revealed:

  • The impermissible disclosure of the PHI of at least 557 individuals to a former employee whose access to PSMC’s information systems was not revoked upon termination of employment.
  • The impermissible disclosure of the PHI of at least 557 individuals to a business associate without an appropriate business associate agreement.

Continue Reading A Pair of Year-End HIPAA Settlements

Imagine a breach in the privacy of protected health information.  The violation of an individual’s HIPAA rights may be clear, but the individual cannot sue under HIPAA.  Courts have consistently held that HIPAA provides no private right of action.

In the recent case of Lee-Thomas v. Lab Corp., an individual brought suit, claiming that her HIPAA rights had been violated.  When hospitalized, she had been  asked to submit medical information on a computer.  She alleged that the information she entered was visible to another patient at a nearby computer station.  The court did not reach the question of whether the proximity of the computers resulted in a HIPAA violation.  It dismissed the claim, observing that HIPAA limits enforcement actions to the U.S. Department of Health and Human Services and states’ attorneys general.

The absence of a private right of action under HIPAA significantly reduces the risks faced by covered entities and business associates, but it does not shield them against all litigation and liability. Lawsuits for the improper disclosure of personal medical information have been brought under different theories, including common law breaches of privacy and breaches of contract.  Last year, Anthem Inc. settled a class action, arising from a large 2015 data breach, for $115 million. Currently, litigation is being pursued under non-HIPAA claims for disclosures that have resulted from mailing practices, including the use of window envelopes and incorrect addresses.  Case law is emerging, and it is possible that courts will refer to HIPAA’s standards as setting the bar for the privacy and data security safeguards that should be implemented and followed, but individuals who sue for breaches of those safeguards will need to base their claims on something other than a HIPAA violation. Continue Reading HIPAA Enforcement: Where’s the Action?